Refractory Erythemato-Squamous Eruption of Facial Skin

Abstract

We present the case of a 46-year-old male patient, Fitzpatrick III phototype, known with primary immune deficiency, who undergoes regular intravenous treatment with normal human immunoglobulin. The patient’s medical history was remarkable for primary immune deficiency, the presence of cervical spondylosis, mixed dyslipidemia and primary arterial hypertension, but he had no prior history of any dermatological complaint. The patient reports 6 months ago the onset of an eruption consisting of nonpruriginous erythematosquamous superficial patches and plaques with a yellow, branny and greasy scale localized on the face, affecting the forehead, supraciliary aspects, nasolabial folds, with extension to both cheeks. Seborrheic dermatitis (SD) is a chronic recurrent erythemato-squamous condition that affects seborrheic areas causing, erythema, flaking and pruritus. Etiology is multifactorial and the role of Malassezia sp. remains controversial (Ruiz-Arriaga et al., Skin Appendage Disord 5(5):288–292, 2019). We present one case of seborrheic dermatitis, which has been resistant to the continuous therapy over 1 year and showed the excess proliferation and overgrowth of Malassezia sp.